"In the political menagerie that is Washington, there exists a species known as the budget scold — analysts, advocates, editorial writers and politicians who possess a fierce determination to bring the federal budget into better balance.

Budget scolds have a wonkish demeanor and a skeptical outlook. They possess an undue fascination with rules and processes, and speak in the arcane language of baselines, sunsets and pay-fors."

Although we don't define ourselves by the fact that we occasionally "scold," the rest of his characterization isn't that far off -- just ask those who run into us at parties. But the point of his article is that Pearlstein is concerned that worries about the budget deficit are going to scuttle health care reform. He writes:

"There have been times when the budget scolds have saved the country from short-sightedness and pulled us back from the fiscal brink. There have been other times — and this is one of them — when their well-intentioned hand-wringing borders on the politically naive and threatens to derail much-needed reforms."

Given that in the past our “hand-wringing” has “saved” us from fiscal ruin (yet was surely criticized at the time), why will our worrying about the costs of health care reform prevent our nation from pursuing the benefits of such reform? Instead of putting a “straightjacket” on the prospects for health care reform, we like to think our concerns are more akin to putting a “thinking cap” on health care reform. Budget constraints don’t derail reforms; they force smarter, more thoughtful reforms that weigh costs against benefits and prioritize accordingly.

How do humans behave when unconstrained? Think all-you-can eat buffets, no-money-down mortgages, or the large deficit-increasing tax cuts of the Bush administration (most of which are continued in the Obama budget).

Yet, the column closes with the thought that:

"In all of history, no revolution was ever made by budget analysts. Health reform requires leaders with the foresight and confidence to take a leap into the unknown."

Of course budget analysts don’t cause revolutions, but even the column allows that perhaps they’ve helped our nation avoid some fiscal disasters. The role of the “fiscal hawk” (a bit better-sounding than a “scold”) is to force policymakers to “get a grip” -- not to encourage them to jump off a cliff with “faith” in a presently-invisible fiscal parachute that might or might not materialize.

And this is the point of our concern about health care reform that is not paid for. If one admits the nation has a huge fiscal challenge in the form of rising spending and a widening gap between that spending and revenues -- and nearly everyone does -- then we need to do everything we can to shrink that gap. Paying for reform just keeps the gap from growing, keeps the situation from not getting worse, while we wait for the cost savings that will hopefully materialize. This itself is a rather bold leap-of-faith because if the savings don't materialize, and no one really knows to what degree they will (even with the best of reforms), we will be years further down the road and deeper in debt because of the compounding of the debt that's already high today.

What the current debate comes down to is whether health care reform is important enough for politicians to be responsible adults and finally suggest reasonable ways to pay for a major national priority. If they cannot come up with a responsible plan to pay for this, what hope do we have that they will ever pay for anything? And ultimately we need them to do much more than pay for something new. They also have to find savings big enough to offset the unsustainable track we are already on. That is why sometimes it seems like we "scold" -- because we expect more from our elected leaders.